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7. Low socioeconomic status exacerbates unmet health‐related needs in patients with autoimmune hepatitis.

Author

Singleton, Carolyn, Carter, Allie, Baker, Brittany, Jones, Emma, Green, Kelsey, Lammert, Craig, and Nephew, Lauren D.

Subjects
AUTOIMMUNE hepatitis, SYSTEMIC lupus erythematosus, INCOME, MEDICAL personnel, LOGISTIC regression analysis
Abstract

Summary: Background and Aims: Diminished quality of life has been well characterized in patients with autoimmune hepatitis (AIH); however, the full spectrum of unmet needs is unclear. We hypothesized that there is a high burden of health‐related unmet needs in patients with AIH, and this burden differs by socioeconomic status (SES). Methods: Members of the Autoimmune Hepatitis Association were invited online and by email to complete a modified version of the Systemic Lupus Erythematosus Patient Needs Questionnaire. Demographic and clinical data were also captured. Low SES was defined as annual household income <30 k, education level below high school, or moderate–high concern for transportation, food or housing. Multivariable logistic regression assessed the association between unmet health‐related needs and SES. Results: There were 433 participants; 89.8% identified as women, 16.2% lived outside the US, and 25.6% were classified as low SES. Over 70% of respondents reported at least one moderate–high need in the health‐related unmet need domains. In multivariable logistic regression, patients in the low‐SES group reported significantly higher odds of unmet needs compared to the moderate–high‐SES group: for adequate information about side effects (OR 1.64, 95% CI 1.06–2.53, p = 0.026), opportunity to speak with others with AIH (OR 2.34, 95% CI 1.50–3.66, p < 0.001), healthcare professionals acknowledging patient emotions (OR 2.41, 95% CI 1.56–3.74, p < 0.001) and being taken seriously by medical providers (OR 2.09, 95% CI 1.34–3.28, p = 0.001). Conclusion: There is a high burden of health‐related unmet needs in all patients with AIH that is exacerbated by low SES. [ABSTRACT FROM AUTHOR]

Published
2024
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12. Incidence, clinical characteristics, and risk factors associated with recurrent alcohol-associated hepatitis

Author

Patidar, Kavish R., primary, Guarnizo Ortiz, Maria, additional, Slaven, James E., additional, Nephew, Lauren D., additional, Vilar Gomez, Eduardo, additional, Kettler, Carla D., additional, Ghabril, Marwan S., additional, Desai, Archita P., additional, Orman, Eric S., additional, Chalasani, Naga, additional, and Gawrieh, Samer, additional

Published
2023
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13. Clinical characteristics and prognosis of hospitalized patients with moderate alcohol‐associated hepatitis

Author

Gaurnizo‐Ortiz, Maria, primary, Nephew, Lauren D., additional, Vilar‐Gomez, Eduardo, additional, Kettler, Carla D., additional, Slaven, James E., additional, Ghabril, Marwan S., additional, Desai, Archita P., additional, Orman, Eric S., additional, Chalasani, Naga, additional, Gawrieh, Samer, additional, and Patidar, Kavish R., additional

Published
2023
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15. Thirty-Day Readmissions Are Largely Not Preventable in Patients With Cirrhosis

Author

Orman, Eric S., primary, Desai, Archita P., additional, Ghabril, Marwan S., additional, Nephew, Lauren D., additional, Patidar, Kavish R., additional, Holden, John, additional, Samala, Niharika R., additional, Gawrieh, Samer, additional, Vuppalanchi, Raj, additional, Sozio, Margaret, additional, Lacerda, Marco, additional, Vilar-Gomez, Eduardo, additional, Lammert, Craig, additional, Liangpunsakul, Suthat, additional, Crabb, David, additional, Masuoka, Howard, additional, Dakhoul, Lara, additional, Pan, Minmin, additional, Gao, Sujuan, additional, and Chalasani, Naga, additional

Published
2023
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21. Thirty-Day Readmissions Are Largely Not Preventable in Patients With Cirrhosis.

Author

Orman, Eric S., Desai, Archita P., Ghabril, Marwan S., Nephew, Lauren D., Patidar, Kavish R., Holden, John, Samala, Niharika R., Gawrieh, Samer, Vuppalanchi, Raj, Sozio, Margaret, Lacerda, Marco, Vilar-Gomez, Eduardo, Lammert, Craig, Liangpunsakul, Suthat, Crabb, David, Masuoka, Howard, Dakhoul, Lara, Pan, Minmin, Gao, Sujuan, and Chalasani, Naga

Published
2024
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22. Clinical characteristics and prognosis of hospitalized patients with moderate alcohol‐associated hepatitis.

Author

Gaurnizo‐Ortiz, Maria, Nephew, Lauren D., Vilar‐Gomez, Eduardo, Kettler, Carla D., Slaven, James E., Ghabril, Marwan S., Desai, Archita P., Orman, Eric S., Chalasani, Naga, Gawrieh, Samer, and Patidar, Kavish R.

Subjects
*HOSPITAL patients, *HEPATITIS, *ACUTE kidney failure, *PROGNOSIS, MORTALITY risk factors
Abstract

Background and Aims: Little is known about the clinical characteristics and prognosis of hospitalized patients with moderate alcohol‐associated hepatitis (mAH) as compared to severe alcohol‐associated hepatitis (sAH). Therefore, we aimed to describe the clinical characteristics and risk factors associated with mortality in hospitalized mAH patients. Methods: Patients hospitalized with alcohol‐associated hepatitis (AH) from 1 January 2010 to 31 December 2020 at a large US healthcare system [11 hospitals, one liver transplant centre] were retrospectively analysed for outcomes. Primary outcome was 90‐day mortality. AH and mAH were defined according to NIAAA Alcoholic Hepatitis Consortia and Model for End‐stage Liver Disease Score ≤ 20 respectively. Multivariable Cox regression analysis was performed to identify independent risk factors associated with 90‐day mortality. Results: 1504 AH patients were hospitalized during the study period, of whom 39% (n = 590) had mAH. Compared to sAH patients, mAH patients were older (50 vs. 48 years, p < 0.001) and less likely to have underlying cirrhosis (74% vs. 83%, p < 0.001). There were no differences between the two groups for median alcohol intake g/day (mAH 140.0 vs. sAH 112.0, p = 0.071). The cumulative proportion surviving at 90 days was 88% in mAH versus 62% in sAH (p < 0.001). On multivariable analysis, older age [HR 1.03 (95% CI 1.00–1.06), p = 0.020], corticosteroid use [HR 1.80 (95% CI 1.06–3.06), p = 0.030] and acute kidney injury (AKI) [HR 2.43 (95% CI 1.33–4.47), p = 0.004] were independently associated with 90‐day mortality. Conclusions: mAH carries a 12% mortality rate at 90 days. Age, AKI and corticosteroid use were associated with an increased risk for 90‐day mortality. Avoidance of corticosteroids and strategies to reduce the risk of AKI could improve outcomes in mAH patients. [ABSTRACT FROM AUTHOR]

Published
2024
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26. Longer time to recovery from acute kidney injury is associated with major adverse kidney events in patients with cirrhosis

Author

Patidar, Kavish R., primary, Naved, Mobasshir A., additional, Kabir, Shaowli, additional, Grama, Ananth, additional, Allegretti, Andrew S., additional, Cullaro, Giuseppe, additional, Asrani, Sumeet K., additional, Worden, Astin, additional, Desai, Archita P., additional, Ghabril, Marwan S., additional, Nephew, Lauren D., additional, and Orman, Eric S., additional

Published
2023
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35. Severe Alcohol‐Associated Hepatitis Is Associated With Worse Survival in Critically Ill Patients With Acute on Chronic Liver Failure

Author

Patidar, Kavish R., primary, Peng, Jennifer L., additional, Kaur, Harleen, additional, Worden, Astin, additional, Kettler, Carla D., additional, Pike, Francis, additional, Buckley, Caitriona A., additional, Orman, Eric S., additional, Desai, Archita P, additional, Nephew, Lauren D., additional, Kubal, Chandrashekhar A., additional, Gawrieh, Samer, additional, Chalasani, Naga, additional, and Ghabril, Marwan S., additional

Published
2021
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47. Severe Alcohol‐Associated Hepatitis Is Associated With Worse Survival in Critically Ill Patients With Acute on Chronic Liver Failure.

Author

Patidar, Kavish R., Peng, Jennifer L., Kaur, Harleen, Worden, Astin, Kettler, Carla D., Pike, Francis, Buckley, Caitriona A., Orman, Eric S., Desai, Archita P, Nephew, Lauren D., Kubal, Chandrashekhar A., Gawrieh, Samer, Chalasani, Naga, and Ghabril, Marwan S.

Subjects
LIVER failure, CRITICALLY ill, INTENSIVE care units, HEPATITIS, ALCOHOLISM
Abstract

Differences in mortality between critically ill patients with severe alcohol‐associated hepatitis (sAH) and acute‐on‐chronic liver failure (ACLF) and non‐sAH ACLF (i.e., ACLF not precipitated by sAH) are unknown. Such differences are important, as they may inform on prognosis and optimal timing of liver transplantation (LT). Thus, we aimed to compare short‐term and longer‐term mortality between patients with sAH ACLF and patients with non‐sAH ACLF who were admitted to the intensive care unit. Patients with ACLF admitted from 2016‐2018 at two tertiary care intensive care units were analyzed. SAH was defined by the National Institute on Alcohol Abuse and Alcoholism's Alcoholic Hepatitis Consortium and Model for End‐Stage Liver Disease score >20. Mortality without LT was compared between sAH ACLF and non‐sAH ACLF using Fine and Gray's competing‐risks regression. A total of 463 patients with ACLF (18% sAH and 82% non‐sAH) were included. Compared to patients with non‐sAH ACLF, patients with sAH ACLF were younger (49 vs. 56 years; P < 0.001) and had higher admission Model for End‐Stage Liver Disease (MELD) (35 vs. 25; P < 0.001) and Chronic Liver Failure Consortium (CLIF‐C) scores (61 vs. 57; P = 0.002). There were no significant differences between the two groups for vasopressor, mechanical ventilation, and hemodialysis use. The cumulative incidence of death was significantly higher in patients with sAH ACLF compared to patients with non‐sAH ACLF: 30‐day 74.7% versus 45.3%; 90‐day 81.9% versus 57.4%; 180‐day 83.2% versus 63.0% (unadjusted subdistribution hazard ratio [sHR] 1.88 [95% confidence interval (CI) 1.44‐2.46]; P < 0.001). After adjusting for CLIF‐C score and infection in a multivariable competing‐risk model, patients with sAH ACLF had significantly higher risk of death (sHR 1.57 [95% CI 1.20‐2.06]; P = 0.001) compared to patients with non‐sAH ACLF. Conclusion: Critically ill patients with sAH ACLF have worse mortality compared to patients with non‐sAH ACLF. These data may inform prognosis in patients with sAH and ACLF, and early LT referral in potentially eligible patients. [ABSTRACT FROM AUTHOR]

Published
2022
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49. 997 Nadir Mean Arterial Blood Pressure During the First Day of Admission to the Intensive Care Unit (ICU) Is Associated With ICU Mortality

Author

Peng, Jennifer L., primary, Russell, Sarah M., additional, Shamseddeen, Hani, additional, Kettler, Carla D., additional, Buckley, Caitriona A., additional, Ghabril, Marwan S., additional, Orman, Eric S., additional, Desai, Archita P., additional, Gomez, Eduardo V., additional, Nephew, Lauren D., additional, Chalasani, Naga P., additional, and Patidar, Kavish R., additional

Published
2019
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50. Admission plasma uromodulin and the risk of acute kidney injury in hospitalized patients with cirrhosis: a pilot study

Author

Patidar, Kavish R., primary, Garimella, Pranav S., additional, Macedo, Etienne, additional, Slaven, James E., additional, Ghabril, Marwan S., additional, Weber, Regina E., additional, Anderson, Melissa, additional, Orman, Eric S., additional, Nephew, Lauren D., additional, Desai, Archita P., additional, Chalasani, Naga P., additional, and El-Achkar, Tarek M., additional

Published
2019
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